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Latest Incurred Claim Ratio of Health Insurance Companies 2021

Latest Incurred Claim Ratio of Health Insurance Companies 2021

Incurred claims ratio (ICR) is the ratio of total claims paid vs. the total net premiums received by the health insurance company. While there are several aspects in choosing a health insurance plan, incurred claim ratio also plays a vital role. One should always check latest incurred claim ratio before opting a health insurance plan. In this article we would provide details as to what is incurred claim ratio and what is the latest Incurred Claim Ratio published by IRDA in 2021.

What is Incurred Claim Ratio?


Incurred Claim Ratio also termed as ICR is the ratio that is computed for a total value of claims paid over the total net premiums received by the health insurance company.

Let us explain with an example.

An X Health insurance company limited has received Rs 100 Crores towards health insurance premiums in a financial year. In the same year, it has paid claims worth Rs 75 Crores. The incurred claim ratio is 75/100 = 75%.

Why it is important to know the incurred claim ratio?


Incurred ratio indicates how much money the health insurance company is retaining as profits.

If the claim settlement ratio is low, means company might be rejecting majority of the claims and retaining majority amount as profits.

If the claim ratio is high, means company is honoring all the claims and might be retaining low profits. Such model might not be sustainable in the long run.

If the claim ratio is moderate (e.g. 60% to 90%), the company has good underwriting standards in issuing policy, as well as honoring the claims and retaining some amount as profits too.

Latest Incurred Claim Ratio of Health Insurance Companies 2021


IRDA releases annual report every year in Dec to Feb period pertaining previous financial year. This annual report contains claim settlement ratios as well as incurred claim ratio.  The data pertain to 2019-2020, but released in 2021.

#1 – Highlights of Latest Incurred Claim Ratio – Private Insurers – 2021


1) Companies that is the quick settlement ratio ( within 3 months ) HDFC Ergo 99.8%, Edelweiss General of 99.72% and Go Digit of 99.65%.

2) Edelweiss General has high incurred ratio of 113%, followed by Shriram General of 96.64% and Iffko Tokio 95.66%.

3) Generally, experts indicate that one should opt for health insurance plans where the insurance company ICR is 70% to 90%. There are 7 insurance companies which fall under this category.  Reliance, Liberty, Raheja QBE, Bajaj Allianz, Bharti Axa, Universal Sompo and Magma HDI.

4) There are two health insurance companies which have very low incurred claim ratio i.e. Navi General of 34.6% and Acko General of 21.08%.

Insurer Incurred Claim Ratio (%) Claims Settled
2018-19 2019-20 Less than 3 months 3 months to 6 months
Edelweiss General 115.35 113.05 99.72 0.24
Shriram General 52.51 96.64 87.53 4.74
IFFCO Tokio 101.92 95.66 81.67 12.8
Reliance 93.55 89.36 98.16 0.68
Liberty 81.64 87.78 97.84 1.31
Raheja QBE 32.87 85.07 30.29 7.21
Bajaj Allianz 85.29 81.96 98.61 0.97
Bharti AXA 88.55 77.5 92.17 5.21
Universal Sompo 92.19 76.68 22.14 26.43
Magma HDI 90.46 72.87 95.4 1.84
ICICI Lombard 76.45 69.9 96.93 1.79
HDFC Ergo 62.29 69.01 99.8 0.12
Tata AIG 77.89 66.61 92.82 5.3
Royal Sundaram 60.52 63.55 97.75 1.04
Future Generali 73.31 62.52 93.34 2.57
Go Digit 10.76 51.83 99.65 0.24
SBI General 52.03 50.54 97.84 1.34
Kotak Mahindra 47.2 49.22 98.62 0.83
Cholamandalam MS 35.3 40.67 91.47 4.47
Navi General* 46.07 34.69 98.7 1.13
Acko General 23.69 21.08 93.49 5.57
Overall Private Insurer Total 75.85 72.55

#2 – Highlights of Latest Incurred Claim Ratio – Standalone Health Insurers – 2021


1) Almost all standalone health insurance companies have a quick settlement ratio (within 3 months) of above 99%, except for Reliance Health Insurance where the ratio is 97.1%.

2) HDFC Ergo tops in a incurred ratio of 73.6%, followed by Star Health of 65.9%.

3) Generally, experts indicate that one should opt for health insurance plans where the insurance company ICR is 70% to 90%. There is only 1 insurance company that falls under this category which is HDFC Ergo.

4) There is one health insurance company where the ICR is below 50%, which is Aditya Birla Health insurance.

Insurer Incurred Claim Ratio (%) Claims Settled
2018-19 2019-20 Less than 3 months 3 months to 6 months
HDFC Ergo Health 62.59 73.69 99.99 0.01
Star Health 62.73 65.91 99.9 0.06
Reliance Health 13.57 62.17 97.13 2.87
Manipal Cigna 61.94 61.64 99.96 0.03
Religare Health 55.23 59.13 100
Max Bupa 53.93 53.51 99.91 0.08
Aditya Birla Health 58.61 49.08 99.36 0.54
Standalone Health Total 60.68 64.13

#3 – Highlights of Incurred Claim Ratio 2021 – Public Sector General Insurers


1) Public Sector health insurance companies quick settlement ratio (within 3 months)  are between 89% to 92.7%, except for National Health Insurance which is 45%.

2) Oriental health insurance tops in a incurred ratio of 104.9%, followed by the United India Health Insurance of 104.2%.

Insurer Incurred Claim Ratio (%) Claims Settled
2018-19 2019-20 Less than 3 months 3 months to 6 months
Oriental 108.80 104.97 92.71 4.34
United India 110.51 104.24 89.18 8.87
National 107.64 103.30 45.37 12.39
New India 103.74 100.83 91.99 4.45
Public Total 107.12 102.91
Suresh KP

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